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自体耳软骨复合皮片移植修复双侧唇裂鼻畸形的效果

Effect of Autogenous Auricular Cartilage Composite Skin Graft for Bilateral Cleft Lip Nose Deformity Repair.

作者信息

Yuan Mei, Jin Jie, Han Yixiang, Ge Xiuyu, Zhao Shuhan, Jia Mengna, Han Zhiqiang, Tian Li, Xu Jing

机构信息

Department of Plastic Surgery, The First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, China.

出版信息

J Craniofac Surg. 2025 May 1;36(3):e313-e317. doi: 10.1097/SCS.0000000000010948. Epub 2024 Dec 27.

Abstract

OBJECTIVE

Bilateral cleft lip nose deformity often involves nasal alar retraction. The use of autogenous auricular cartilage for correction further aggravated nasal alar retraction caused by nasal lining defects after the operation. A novel graft was developed to address bilateral cleft lip nose deformity. This graft effectively addresses the lining defect and avoids nasal alar retraction following surgical intervention.

METHODS

Seventeen patients (7 males and 10 females) with bilateral cleft lip nose deformity were treated at the authors' institution. All patients underwent repair with an auricular cartilage-composite skin graft. The surgical effect was evaluated from 4 aspects: nasal flange position, postoperative appearance satisfaction, nasal aesthetic subunit index, and three-dimensional difference.

RESULTS

Postoperatively, 17 patients with bilateral cleft lip nose deformity were followed up from 3 months to 1 year, none of them had any obvious inward collapse or recession of the nasal margin ( P > 0.05), and all of them showed satisfactory results. The satisfaction rate was above 90% ( P < 0.01). The nasal tip angle and nasolabial angle were significantly smaller postoperatively than those preoperatively ( P < 0.01). The nostril height and nasal columellar height were greater postoperatively than those preoperatively ( P < 0.01). A comparison of the three-dimensional spatial differences revealed that the appearance of the nasal deformity was noticeably better after surgery ( P < 0.01).

CONCLUSIONS

Auricular cartilage-composite skin graft repair is highly effective for enhancing nasal support, correcting nasal tip shape, effectively resolving nasal flange recession, and preventing nasal flange retraction in the postoperative period.

LEVEL OF EVIDENCE

Level IV.

摘要

目的

双侧唇裂鼻畸形常伴有鼻翼退缩。使用自体耳软骨进行矫正会进一步加重术后因鼻内衬缺损导致的鼻翼退缩。研发了一种新型移植材料来解决双侧唇裂鼻畸形问题。这种移植材料能有效解决内衬缺损问题,并避免手术干预后鼻翼退缩。

方法

作者所在机构对17例双侧唇裂鼻畸形患者(7例男性,10例女性)进行了治疗。所有患者均接受了耳软骨复合皮片修复。从鼻缘位置、术后外观满意度、鼻美学亚单位指数和三维差异4个方面对手术效果进行评估。

结果

术后,17例双侧唇裂鼻畸形患者随访3个月至1年,无一例鼻缘出现明显向内塌陷或退缩(P>0.05),且均取得满意效果。满意度率在90%以上(P<0.01)。术后鼻尖角和鼻唇角明显小于术前(P<0.01)。术后鼻孔高度和鼻小柱高度大于术前(P<0.01)。三维空间差异比较显示,术后鼻畸形外观明显改善(P<0.01)。

结论

耳软骨复合皮片修复对于增强鼻支撑、矫正鼻尖形状、有效解决鼻缘退缩以及防止术后鼻缘退缩非常有效。

证据水平

四级。

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